How do I know if I need a lawyer for my insurance claim? Here are five tips to help you figure it out

Written by Plaintiff Litigation Group PLLC

Although many people deal with health insurance claims on a regular basis, most of us only rarely have a homeowner, auto, life, liability or other kind of claim. Unless you’re in the insurance or legal industry, you’re unlikely to know the rules that apply to insurance claims. The insurance adjuster, on the other hand, knows the rules. Adjusters are trained to make you feel like everything is under control. Sometimes people who run into problems with their claims come to find out too late that there were warning signs all along. A lot of people have a vague feeling they might need legal help, but the process for finding a lawyer who knows the ins and outs of insurance seems really intimidating.

The purpose of this guide is to give you some tips as you consider whether you need to get legal help with your insurance claim.

No. 1. Most people don’t get lawyers.

In most cases, the claim is opened, the insurance company makes its decision, and the person making the claim lives with the company’s decision.

This isn’t necessarily a good thing. Insurance companies are motivated by profit, and sometimes adjusters are rewarded if they lower claims payments. If people are afraid to disagree or to push back on the insurance company—or if they don’t know their rights—then insurance companies know they can get away with paying less than they’re required to under the insurance policy. Multiply this over thousands or millions of claims a year, and the public can be robbed of millions of dollars of benefits.

No. 2. You’ve got important protections under the law.

Under Washington law, it’s the insurance company’s legal obligation to fully, fairly, and promptly investigate your claim. The law imposes timelines for that investigation to occur. Legal regulations don’t allow the insurance company to drag out the investigation. If an expert has to be hired to determine the extent of the damage, then it’s the insurance company’s job to hire that expert and make a determination about the amount of money you’re owed. The insurance company has a legal duty to explain your rights to you in a way that you can understand. It isn’t allowed to keep you in the dark. There are strict timelines for responding to your communications.

No. 3. Here are some signs that you might need a lawyer.

In a decade-plus of experience suing insurance companies and helping claimants, patterns have emerged that give a good idea when a person should consider making an appointment with a lawyer. If any of these is happening, it’s probably a good idea to consult with an attorney.

  • Your adjuster isn’t returning your phone calls.
  • You feel like no progress is being made on the claim.
  • The insurance company keeps asking for the same information over and over.
  • You feel like the adjuster is making you investigate the claim instead of conducting the investigation, itself.
  • In a homeowner insurance claim, the insurance company is making you live in a house that is unsafe for you or your family.
  • You’ve been living in a hotel that isn’t meeting your family’s needs.
  • You’re feeling pressured to sign off on a settlement that you’re not comfortable with.
  • The adjuster is telling you not to worry about a low estimate and that you can make a supplemental claim later.
  • You’ve been contacted by the insurance company’s lawyer.
  • The insurance company assigned your claim to the Special Investigations Unit (also called the "SIU").
  • The insurance company is asking for an examination under oath (also called an “EUO”).
  • Something inside of you is telling you that you shouldn’t trust the insurance company or the adjuster.

No. 4. You don't have to pay for a consultation.

Don’t delay just because you think you can’t afford legal advice. There are many lawyers—including the Plaintiff Litigation Group—that will consult with potential clients for free. If there has to be a lawsuit, many lawyers—including our firm—will often represent clients on a contingent-fee basis, meaning that the firm only gets paid if you obtain a recovery.

No. 5. Here are some things you should keep in mind when choosing a lawyer.

Knowing how to pick a lawyer is difficult, but here are some tips:

  • Choose a lawyer who is experienced in insurance bad-faith cases and Insurance Fair Conduct Act cases.
  • Fighting an insurance company can be stressful and can last a long time. Choose someone who you feel comfortable with and who you feel will be by your side over the long haul.
  • Remember that the case will have to be presented to a judge and jury made up of real people. Is this someone who you are comfortable serving as your spokesperson in court?
  • Lawyers have earned a bad reputation for failing to communicate with their clients. Clients often feel left out of the process. Choose a lawyer who is committed to client service and who will ensure you receive all the information you want when you want it.
  • Make sure you understand the fee agreement. If the fee agreement is written in a way that makes it hard to understand, this isn’t fair to you or a good sign for the type of communication you’ll see from the attorney.
  • Watch out for “costs.” Even in the paperless era we live in, some firms print or copy so many pages at your expense that thousands of dollars are subtracted from your settlement at the end of the case. You should ask about these when you meet the lawyer.


We hope this has been helpful. For more information, visit our website, www.plaintifflit.com, or call for a free consultation, 206-203-9100. You can also click the button below to contact us.

Created By
Isaac Ruiz


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